Inspection on 21/08/06 for St Anthony`s Cheshire Home

This inspection was carried out on 21st August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Anthony`s Cheshire Home 31/01/06

St Anthony`s Cheshire Home 27/09/05

St Anthony`s Cheshire Home 06/01/05

St Anthony`s Cheshire Home 30/06/04

Similar services:

Aston Court Nursing Home

Breme

Ravenhurst

Westmead

Ashcroft Hollow Nursing Home

Bricklehampton Hall Nursing Home

Briar Hill House

Radbrook Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 St Anthony`s Cheshire Home Stourbridge Road Penn Wolverhampton West Midlands WV4 5NQ Lead Inspector Lynne Gammon Key Unannounced Inspection 21 August 2006 09:30 St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Anthony`s Cheshire Home Address Stourbridge Road Penn Wolverhampton West Midlands WV4 5NQ 01902 893056 01902 326376 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.leonard-cheshire.org.uk Leonard Cheshire Mrs Elizabeth Olwen Keenan Care Home 35 Category(ies) of Physical disability (35), Physical disability over registration, with number 65 years of age (12) of places St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: St Anthony’s Cheshire Home is located on the A449 between Wolverhampton and Wombourne. The Home was established in 1961 to provide care for all ages that have a physical disability. The Home is a mixture of styles including very modern purpose-built, mainly single room accommodation spread out on ground floor level in extensive grounds, surrounded by countryside of outstanding beauty. The general philosophy of care is to promote a sense of independence in a personal, individualised environment. The Home is superbly equipped and very organised, whilst presenting an informal yet professional quality of care. There is however opportunity for friends and married couples to share an ample sized, comfortable room if so wished. In August 2006 information from the registered care manager identified that the fees for the service ranged from £600 to £1650 per week depending upon individual need and other contributions from other agencies or individuals. Additional charges were also made for toiletries, hairdressing facilities, newspapers/magazines, clothing, optical and dental services, holidays, theatre trips and motor mileage. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was made on the 21st August 2006 at 9.30 a.m. The inspection was carried out by one inspector, who used the National Minimum Standards for Adults (18 – 65) as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to 9 hours. The inspection included a tour of the building, inspection of records, observation, and discussions with service users, relatives and staff. Service users spoken to stated that they were very happy living at St Anthony’s Cheshire Home. One commented as follows: ‘Carers listen to, and respect my wishes’ and ‘I consider the majority of the staff to be my friends’. One relative commented ‘Residents are looked after to a very high standard, and the home provides a safe and understanding sanctuary for residents and their relatives alike. It is like one big family, working to give everyone comfort and confidence – with the staff (caring, kitchen and cleaning) willing to do over and above their duties to provide the best possible environment for so diverse a selection of disabilities. The management and office staff provide a strong backbone for this level of care, providing support whenever it is needed, and total reassurance’. Other comments from relatives included ‘It is hard to get anyone to answer the phone’ and ‘We find a lack of day to day information … and also a lack of continuity of key worker especially for attending 6 monthly reviews’. What the service does well: Service users had full, detailed assessments prior to moving into the home and the home encouraged the service users to be as independent as possible and to make their own decisions and choices about their lives. They were also supported to take risks. The care planning processes within the home were well documented and informative to enable staff to meet the needs of the service users. A variety of social activities within the home and community were available to the service users and they were provided with support and assistance to develop and learn new skills within the home. Some service users accessed training from the local college and all were able to continue to maintain contact with family and friends. The health and well being of the service users was closely monitored and access to health professionals was provided. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 6 No formal complaints had been received by the Commission for Social Care Inspection. Management systems in the home were robust, supporting the staff and service users. The home was well managed and provided an open and positive atmosphere for the service users and staff. What has improved since the last inspection? What they could do better: One requirement was raised as a result of this inspection, as follows: • For each staff file to contain a current photograph of each relevant staff member as set out in Schedule 2 of the Care Homes Regulations 2001. Two recommendations were also made as follows: • • For those service users who are vegetarian to be asked to provide suggestions to broaden the choices of menus available to them. For a review of gardening hours to be undertaken to determine if sufficient time is allocated to St. Anthony’s for garden maintenance. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users received full, detailed assessments prior to moving into the home, which were used as the foundation for a comprehensive care plan for the benefit of the service user. EVIDENCE: Records showed that detailed pre-admission assessments were carried out for each individual service user and service users were involved in the assessment with appropriate assistance provided as required. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care planning processes within the home were well-documented and informative to enable staff to meet the needs of the service users. Service users were able to make their own decisions and choices about their lives and supported to take risks. EVIDENCE: The care plans were detailed and provided sufficient information for staff to have a clear understanding of service user’s needs and how those needs should be met. Risk assessments were also in place and both these and the care plans were reviewed monthly. Within the care plan it was observed that service users were involved in all aspects of their care and signed the care plan accordingly. There were numerous examples of service users making their own decisions and choices. One service user confirmed that she had access to her own care St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 10 plan and she was listened to when she wanted to make her own choices. Her choices were seen recorded in the care plan and risk taking was documented and agreed. Another service user, who was a recent admission, also confirmed that since moving into the home, he was extremely happy with the staff, the accommodation and the support to be as independent as possible. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users had access to a variety of social activities within the home and the community. Service users were provided with the support and assistance to develop and learn new skills within the home. Younger service users accessed local colleges and all were able to continue to maintain contact with family and friends. Appropriate relationships were supported and encouraged and service users rights were respected. A well balanced and nutritious menu was provided for the benefit of the service users. EVIDENCE: St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 12 Service users and staff confirmed that service users had a range of social activities to meet their different needs. A survey completed by service users earlier in the year had been analysed and the information from this analysis had been used to begin to develop specific activities to meet individual needs. The service users and staff had also been successful in accessing College services 4 afternoons per week at the home which included horticulture, arts and crafts and a possibility of learning life skills. Staff confirmed that the activities room was going to be refurbished and turned into an area for life skills rehabilitation for service users. Most service users and relatives were complimentary about the activities and interests that were available in and outside the home, however one relative felt that ‘the younger residents especially need more to do’. Service users confirmed that they were able to maintain contact with their family and friends. During the course of the inspection, discussions with relatives evidenced a high level of satisfaction with the service provided by the home. One relative made comments in a completed questionnaire sent directly to the Commission as follows: ‘In my opinion, the care is 5 star. The staff are always pleased to assist residents, relatives and visitors’. Service users confirmed that their rights were respected. One service user in a completed questionnaire sent directly to the Commission stated ‘Within reason and the restrictions of my disability, I have a lot of freedom’. He also stated ‘There are lots of people I can speak to if I’m unhappy, I am aware of the complaints procedure and I consider the majority of staff to be my friends’. Menu plans were seen and service users were invited to comment on the menus and their views taken into account. Most comments regarding the food were positive, however one relative stated ‘my daughter who is vegetarian has a very limited diet’. It is recommended that service users who are vegetarian be asked to provide suggestions to broaden the choices available. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s practices, systems and procedures ensured the personal support needs of the service users were met. Records evidenced that service users health care needs were clearly identified and met. Medication procedures and practices were robust for the protection of the service users. EVIDENCE: Observation and detailed care plans provided evidence of personal support being delivered in a respectful and dignified manner. On the day of the inspection, it was observed that service users were able to get up when they wanted to, chose their own clothing and went out as agreed with staff. It was noted that the service users made numerous other choices throughout the day. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 14 Care plans also evidenced that service users had access to a range of other health professionals including a physiotherapist, GP etc and health care needs were seen to be well documented and met well. Records showed that advocates had been accessed for the benefit of the service users when required. Medication administration, receipt, storage and disposal processes were inspected and seen to be accurate and balanced with all records and stock levels. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A robust complaints procedure was in place and service users were listened to with their views taken into account. The homes’ Adult Protection procedure and staff training ensured they were protected from abuse. EVIDENCE: The Commission for Social Care Inspection had not received any formal complaints since the last inspection. Two complaints had been received by the home and the complaints log provided very good recording of the complaints made and action taken to resolve the issues. The complaints recording system within the home was transparent and thorough with timescales met on each occasion for the benefit of the complainant. Service users confirmed that they did not have any complaints but did have copies of the procedure if they needed it. One resident stated ‘Don’t need to complain’. A copy of the complaints procedure was available for visitors and relatives in the home. One allegation of abuse had been received since the last inspection and this was investigated via the Protection of Vulnerable Adults procedures which involved CSCI and other key agency representatives and appropriate action was taken to maintain the safety of the service users. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was overall well maintained apart from some areas of the garden, which required attention. The home was homely, comfortable and clean for the benefit of the service users. EVIDENCE: A tour of the home took place, both inside and out. The home was overall well maintained internally, with a number of improvements having been made since the last inspection including a new physiotherapy suite, new carpeting and new dining room table and chairs. Each bedroom was individually personalised and all rooms had special locks on the doors which were easily accessible to the service users. Some new windows had been put in and had made a significant difference to some of the rooms. Externally, the home was almost surrounded by gardens and it was clear that efforts had been made to improve some areas of garden. However, one patio St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 17 area needed to be weeded and some other areas were in need of attention. It is recommended that a review of gardening hours be undertaken to determine if sufficient time is allocated to St. Anthony’s for garden maintenance. A car parking area was also available at the rear. The home was very clean and free from any offensive odours. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. NVQ training continued to ensure that qualified staff supported service users. The recruitment practices within the home were robust but required a photograph of each individual staff member to be kept on their file for the protection of the service users. Staff were appropriately trained in order to meet service user’s needs. EVIDENCE: The home employed 31 care staff and at the time of the inspection 19 members of staff had obtained NVQ level 2 or 3 in care and therefore the home met the recommended target of having at least 50 of care staff trained to NVQ level 2 working in the home. 3 staff files were examined and found to contain all required elements as set out in Schedule 2 of the Care Homes Regulations 2001 except for a photograph of the individual staff member. It is a requirement of this report that this is addressed and a current photograph is obtained for each relevant staff member. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 19 Training records evidenced that a wide range of training had already been completed this year including POVA, Moving and Handling, Food Hygiene, Fire Awareness, Health and Safety etc and further training was seen planned for the rest of 2006 for staff. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered manager was a fit and competent manager for the benefit of the service users. Quality assurance systems were in place to determine the success of the service and service user feedback was encouraged. The health, safety and welfare of service users and staff were protected. EVIDENCE: The registered manager was a qualified nurse and an experienced manager, fully able and competent in running the home. Service user’s meetings took place regularly and minutes were seen showing service user requests and suggestions being listened to and actioned. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 21 The health, safety and welfare of service users and staff were promoted and protected. A number of records were examined and evidenced that on-going inspections were carried out to maintain safety. These included: hoists checked on 16/08/06, the lift was serviced on 26/01/06, the fire alarm and nurse call alarm were inspected on 12/06/06, the fire extinguishers were serviced in February 2006, the 5 year electrical installation certificate was issued on 14/06/04, the gas safety inspection was carried out on 23/09/05 and the home had an environmental health inspection on 2/12/05. All of the above were found to be satisfactory. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 x 3 X 3 X X 3 x St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 19 (1)(b) (i) Requirement For each staff file to contain a current photograph of each relevant staff member as set out in Schedule 2 of the Care Homes Regulations 2001. Timescale for action 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA17 YA24 Good Practice Recommendations For those service users who are vegetarian to be asked to provide suggestions to broaden the choices of menus available to them. For a review of gardening hours to be undertaken to determine if sufficient time is allocated to St. Anthony’s for garden maintenance. St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Anthony`s Cheshire Home DS0000022368.V305699.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!